CLINICAL RESEARCH: EFFECTS OF STATIN THERAPY
Long-term statin use and psychological well-being
Yinong Young-Xu, MS, MA* ,*,
K. Arnold Chan, MD,
James K. Liao, MD, FACC ,
Shmuel Ravid, MD, FACC* and
Charles M. Blatt, MD, FACC*
* Lown Cardiovascular Research Foundation, Brookline, Massachusetts, USA
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
Department of Medicine, Brigham and Women's Hospital, Boston, MassachusettsUSA
Department of Nutrition, Harvard School of Public Health, Boston, MassachusettsUSA
Manuscript received April 11, 2003;
accepted April 30, 2003.
* Reprint requests and correspondence: Yinong Young-Xu, Lown Cardiovascular Center, 21 Longwood Avenue, Brookline, Massachusetts 02446, USA.
yyoungxu{at}hsph.harvard.edu
OBJECTIVES: We sought to study the effect of long-term statin use on psychometric measures in an adult population with underlying coronary artery disease (CAD).
BACKGROUND: Previous studies have suggested associations between cholesterol lowering and psychological well-being.
METHODS: Study subjects were recruited from an outpatient cardiology clinic. Psychological well-being was assessed at baseline and annually during follow-up. The exposure of interest was long-term statin use and the outcomes of interest were depression, anxiety, and hostility. We estimated the odds ratios (ORs) and 95% confidence intervals (CI) that represented the strength of association between statin use (vs. no use of any cholesterol-lowering drug) and the risk of having abnormal depression, anxiety, and hostility scores.
RESULTS: Study subjects had an average follow-up of four years and maximum of seven years. Comparing the 140 patients who had continuous use of statins with the 231 patients who did not use any cholesterol-lowering drugs, statin use was associated with lower risk of abnormal depression scores (OR 0.63, 95% CI 0.43 to 0.93), anxiety (OR 0.69, 95% CI 0.47 to 0.99), and hostility (OR 0.77, 95% CI 0.58 to 0.93) after adjustment for the propensity for statin use and potential confounders. The beneficial psychological effects of the statins appeared to be independent of the drugs' cholesterol-lowering effects.
CONCLUSIONS: Long-term use of statins among patients with CAD appeared to be associated with reduced risk of anxiety, depression, and hostility.
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Abbreviations and Acronyms
| | CAD | | coronary artery disease | | GEE | | generalized estimating equations | | MI | | myocardial infarction | | SQ | | (The Kellner) Symptom Questionnaire |
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